Every six months or so, headlines proclaiming the doom of people who like to run seem to pop up like little schadenfreude sundaes.  People love to tell runners that all their hard work is likely causing more harm than good, and after the deaths of celebrities like Jim Fixx, Micah True, and even poor old Pheidippides (he of Marathon fame), it is a little scary to contemplate. But how good is the science behind this idea?  Are you really likely to die mid-run?

TL:DR version?

Exercise, any exercise at all, is generally good for you.  It will increase your lifespan, reduce your risk of diabetes, reduce excess weight, and more.  Most people don’t get near enough.  Do some people die during marathons?  Yes, but it’s unclear whether marathons actually elevate your risk of early death–those people had underlying structural abnormalities or atherosclerosis already.  And the clinical significance of any kind of heart damage marker following extreme exercise is unclear–long distance athletes live longer than sedentary or even moderately active people, so it doesn’t appear that these markers mean anything in this population.


  1. What is the right amount of exercise for maximizing lifespan?  “I have no idea — though my answer for 99.99% percent of people would be “More than what you’re doing right now.” — Alex Hutchinson, science writer
  2. Remember Jim Fixx–lots of running won’t fix a bad diet
  3. If you’re feeling weird, talk to you doctor! Some cases of hypertrophic cardiomyopathy and athersclerosis can have symptoms like heartburn, tightness in the chest and arms.

Studies mentioned in the episode:

Pheidippides probably didn’t die

The rate of cardiac arrest in marathons is 1/184,000 participants

Atherosclerotic heart disease tends to be the cause of death during marathons

Marathons prevent deaths from traffic accidents

Cardiovascular disease is the leading cause of death worldwide

Even small amounts of running massively decrease your risk of death from heart disease

Among runners, those who run more need fewer diabetes and cholesterol-lowering drugs

Similarly, more intense running reduces diabetes and cholesterol drug use

Student athletes have fewer heart attacks than the general population

Most people are less active than they think they are

Copenhagen heart health study about risks of strenuous jogging

O’Keefe softens his stance, says 5-6 days of running/wk for total of less than 5 hours is probably ok

Running helps prevent diabetes, high blood pressure, and cardiovascular disease

Marathon runners have higher rates of markers of heart damage

Recreational Boston Marathon runners have elevated markers of heart damage following the race

Ironmans do not cause increases in heart damage markers

Recreational Berlin Marathon runners have elevated markers, but no indication of actual heart damage

Elevated heart damage markers following exercise likely are not meaningful

Cardiac arrhythmias are reduced following marathons

Alex Hutchinson attacks the “running too much” myth


Cover photo by mebrett is licensed under CC BY 2.0


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